This study aimed to estimate the trend of traumatic brain injuries (TBIs) and TBI-related medical usage in Korea. Patients first diagnosed with disease codes of TBIs were included.We calculated the crude incidence and age-adjusted incidence, as well as medical cost, length of stay (LOS), clinic visits, and the number of specialized rehabilitation therapy for 1 year. Patients first diagnosed as TBI was higher in national health insurance (NHI) than in automobile insurance (AUTO-I). In contrast with the gradual decrease of the crude incidence, total medical costs both in NH-I and AUTO-I were generally and steadily increased. For oriental medicine, total medical costs dramatically increased in both inpatient and outpatient. LOS, clinic visits, and the number of specialized rehabilitation therapy were higher in AUTO-I than in NH-I. The most frequent age groups in NH-I were the young (0–9) and old (70 or over), whereas in AUTO-I, the working age group was prominent. Our results show differences in the incidence of TBI and medical usage between NH-I and AUTO-I, which could be associated with the policy for strengthening health insurance coverage, automobile-related regulations to prevent accidents and injuries, as well as rapid changes in the structure of the population in Korea.

Spinal cord injury (SCI) has been recognized as a medically complex and life-disrupting condition. As the aging of the population accelerates, the trend of SCI has changed. This review aimed to provide comprehensive statistics and recent epidemiological changes in SCI and rehabilitation in Korea. All three insurance databases (National Health Insurance Service [NHIS], automobile insurance [AUI], and industrial accident compensation insurance [IACI]) were considered. These nationwide databases provide data on the current trends in term of incidence, etiology, and rehabilitation of SCI. Traumatic spinal cord injury (TSCI) was more frequent among the elderly in the NHIS compared to working age individuals in the AUI and IACI. In all three trauma-related insurance databases, male with TSCI outnumbered female. TSCI incidence per year was approximately 17 times higher among males than females, on average, in IACI. In all three insurances, the cervical level of TSCI was the most frequent. Although the ratio of SCI patients receiving rehabilitation treatment at primary and secondary hospitals increased for nine years, the increase in training on activities of daily living (ADL training) was found to be relatively small. This review provides a broader and comprehensive understanding of the incidence, etiology, and rehabilitation treatment of SCI in Korea.

Background: To examine the incidence of traumatic spinal cord injury (TSCI) from all etiologies, we measured and compared the incidence of TSCI from three national or quasinational databases in South Korea, namely, the National Health Insurance Service (NHIS), automobile insurance (AUI), and Industrial Accident Compensation Insurance (IACI). Methods: We reviewed patients with TSCI reported in the NHIS database between 2009 and 2018, and in the AUI and IACI databases between 2014 and 2018. TSCI patients were defined as those first admitted to the hospital with a diagnosis of TSCI according to the International Classification of Diseases (10th revision) criteria. Age-adjusted incidence was calculated using direct standardization using the 2005 South Korean population or the 2000 US population as the standard population. The annual percentage changes (APC) of TSCI incidence were calculated. The Cochrane–Armitage trend test was performed according to the injured body region. Results: In the NHIS database, age-adjusted TSCI incidence using the Korean standard population increased significantly from 2009 to 2018 (from 33.73 per million in 2009 to 38.14 per million in 2018, APC = 1.2%, P = 0.014). Contrarily, age-adjusted incidence in the AUI database significantly decreased from 13.88 per million in 2014 to 11.57 per million in 2018 (APC = – 5.1%, P = 0.009). In the IACI database, the age-adjusted incidence showed no significant difference, while crude incidence showed a significant increase (from 22.02 per million in 2014 to 28.92 per million in 2018, APC = 6.1%, P = 0.038). According to the age group, all the three databases showed high incidences of TSCI in those in their 60s and 70s or older. Among those in their 70s or older, the incidence of TSCI increased dramatically in the NHIS and IACI databases, while no significant trend was found in AUI database. In 2018, the number of TSCI patients was the highest among those over 70 years of age in the NHIS, whereas among those in their 50s were the highest in both AUI and IACI. The proportion of patients with cervical spinal cord injury was the most common in all these databases. Conclusions The differences in trends in the incidence of TSCI may be due to the different etiologies and different characteristics of subjects depending on insurance type. These results imply the need for tailored medical strategies for the different injury mechanisms represented by three national insurance services in South Korea.

Acquired brain injury (ABI) is a leading cause of serious long-term disability resulting in substantial economic costs for post-ABI care. This study was conducted to estimate the socioeconomic burden of persons with ABI in Korea. We used a prevalence-based approach and societal perspective to estimate the direct medical, non-medical costs and indirect costs of ABI, including stroke, traumatic brain injury (TBI), and non-traumatic ABI (anoxia, brain tumor, encephalitis, meningitis, hydrocephalus, and other brain disorders) from 2015 to 2017. The study population included patients with ABI over 20 years of age and analyzed according to insurance types encompassing National Health Insurance and automobile insurance. The socioeconomic burden of ABI was 4.67, 5.18, and 5.73 trillion KRW (approximately 4,162, 4,612, and 5,106 million USD) from 2015 to 2017 and around 0.3% of Korea's GDP annually. Estimating by disease, the socioeconomic cost was 72.4% for stroke, 18.6% for TBI, and 9.0% for non-traumatic ABI. Calculated by cost component, medical costs and non-medical costs showed a slight increase every year. Through this study, establishment of rehabilitation systems maximizing the health and quality of life for injured persons remain the key public health strategy for ABI to reduce socioeconomic burden and financial policies to support patients should be needed.

The purpose of this study was to develop a curriculum for the oriental clinical nurse specialist program based on the understanding of Korean human beings so as to develop nursing as a profession and promote the client's health. The design of this study was based on literature review and nominal group study. The research was managed by East-West Nursing Research Institute of nursing science college at Kyung Hee University. The research team was composed of 17 professors of nursing departments of oriental medical colleges. We obtained opinions from Oriental Nurses Association, Oriental Nursing Research Association, and professors in oriental medical college. We reviewed articles, curriculums of other clinical nurse specialist programs, medical laws and the curriculum development plan for the oriental clinical nurse specialist program from Korean Nurses Association. We discussed a curriculum thoroughly in numerous meetings. We developed a following curriculum: 1. Educational philosophy was founded on the oriental human view which was based on Chun-In union theory. It was founded on the oriental health view which recognized health being in harmony with nature and the balance of body function with the harmony of Yin-Yang in the five elements. In addition, it was founded on oriental nursing view to promote these health states. 2. Educational goals were to train oriental clinical nurse specialists, oriental nursing educators and oriental nursing researchers who developed knowledge of oriental nursing theory, nursing practice and created a leadership. 3. Curriculum consisted of 48 credits, of which 36 credits are based on lectures and laboratory classes and 12 credits are based on clinical practice. 36 credits consisted of 5 general subject credits and 31 core subject credits. General subjects consisted of nursing theory, nursing research, law and ethics. Students who had earned master's degrees are not required to take the general subjects. Core subjects consisted of 11 subjects such as advanced physical examination and laboratory, oriental nursing theory, original text of oriental nursing, oriental medical nursing, oriental pediatric nursing, oriental gynecologic nursing, oriental gerontologic nursing, oriental pharmacology, oriental constitutional nursing, advanced nursing of channels and acupuncture points and laboratory and oriental rehabilitation nursing and laboratory. In addition, clinical practice in a hospital ward, out patient department, herb prepation room, department of physical therapy and health promotion center in oriental medical hospitals for 12 weeks. To admit this program, students should complete prerequisites of introduction to oriental nursing and nursing of channels and acupuncture points. 4. Course contents of each subjects were developed to include the course's goal and objectives and specific items. 5. Evaluation involved lecture, laboratory and in field practice. We applied various evaluation systems and methods that were based on both knowledge and skills of the students to ensure full credibility and validity.
Acupuncture Points ; Curriculum* ; Ethics ; Health Promotion ; Humans ; Jurisprudence ; Leadership ; Lectures ; Nurse Clinicians* ; Nursing ; Nursing Research ; Nursing Theory ; Pediatric Nursing ; Pharmacology ; Philosophy ; Physical Examination ; Rehabilitation Nursing ; Social Change ; Yin-Yang